Hand problems Flashcards

(30 cards)

1
Q

What is a mucous cyst?

A

outpouching of synovial fluid from DIP joint
may deform the nail and cause a ridge and discharge
painful
can be excised or left alone

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2
Q

What is a ganglion?

A

outpouching of the synovial cavity

resolved with excising or aspirate

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3
Q

What is trigger finger?

A

swelling of tendons in the tendon sheath causing the tendon to get caught on the edge of the A1 pulley (usually in flexion)

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4
Q

What are the examination findings for trigger finger?

A

feel the nodule pass beneath the pulley usually in flexion, it makes a clicking sound

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5
Q

What is the mangement of trigger finger?

A

can resolve spontaneously
splint
give steroid injections into tendon sheath - can cure
surgery to divide A1 pulley

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6
Q

What fingers are most commonly affected by trigger finger?

A

middle finger

ring finger

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7
Q

What is DeQuervians Tenosynovitis?

A

painful, red, swollen thumb

comes on spontaneously due to inflammation of tendons a the side of the wrist and base of the thumb

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8
Q

How is DeQuervians Tenosynovitis diagnosed?

A

Finklesteins test

Ultrasound

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9
Q

How is DeQuervians Tenosynovitis managed?

A

rest - splint
NSAIDs
steroid injections
decompression

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10
Q

Who is more likely to get DeQuervians Tenosynovitis: males or females?

A

females

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11
Q

What is Dupuytrens contracture?

A

thickening and contracture of the subepidermal fascia, leading to a fixed flexion deformity of the fingers
it is an avascular process involving O2 free radicals

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12
Q

What type of collagen is laid down in Dupuytrens contracture?

A

type 3 collagen

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13
Q

How does Dupuytrens contracture present?

A

starts: palmar pit nodule then progresses to a fixed flexion deformity
normally males

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14
Q

What is Dupuytrens contracture due to?

A
genetics
alcohol - cirrhosis
diabetes
smoking
epilepsy
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15
Q

What is the examination for Dupuytrens contracture?

A

table top test

examine/feel hands

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16
Q

What is the treatment for Dupuytrens contracture?

A

stretches
surgery - segmental fasiectomy, amputation, dermofasciectomy
collagenase injections

17
Q

What is a paronychia?

A

an infection within the nail fold commonly seen in children due to nail biting - results in pus

18
Q

What is the treatment for paronychia?

A

antibiotics
incise and drain collection
elevate

19
Q

What is a flexor tendon sheath infection?

A

EMERGENCY

tracts up the arm, extremely painful

20
Q

What is the management of a flexor tendon sheath infection?

A

wash out the tendon sheath

21
Q

What are the side effects of a flexor tendon sheath infection?

A

lymphangitis

limited extension of arm

22
Q

What is a mallet finger caused by?

A

an avulsion fracture

23
Q

What is the treatment of mallet finger?

A

splint for 6 weeks

dermatotendesis in chronic cases

24
Q

Why do PIP dislocations need to be treated acutely?

A

need to be reduced acutely otherwise it will need fusion

25
What is Eschar?
thick, leathery skin that forms after burns and requires surgical release
26
What sign does wrist instability present with?
Terry thomas sign on Xray - scapoid lunate ligament rupture | - treated with 4 corner fusion and proximal row carpectomy or total wrist arthrodesis
27
What is the presentation of swan neck deformity?
HYPEREXTENDED pip | flexed dip
28
What is the presentation of boutonniere deformity?
flexed pip | HYPEREXTENDED dip
29
What causes a boutonniere deformity?
extensor hood of PIP becomes attenuated meaning that the slips of the extensor tendon moves from dorsal -> volar -> centre of rotation causing flexion of the PIP and the middle phalange buttonholes through the extensor hood
30
How is boutonniere and swan neck deformities treated?
splint and tendon reposition